How millions of women are being let down by flood relief efforts in Pakistan

With barely enough resources to provide specialist medical care, it is uncertain when, and if, the victims will receive the psychosocial support that is so evidently lacking.
Published October 7, 2022

Disaster certainly photographs well. For those far away from it, it generously condenses itself to fit into smartphone screens, the perfect size to click, share and briefly lament over.

The power of crisis photography is undeniable — there is a reason why the most successful calls to donation are those supplemented by a truly moving photograph. The logic is simple: We see, we feel, and occasionally, we act.

But what happens to the causes that are more elusive, too grotesque or simply ‘unphotographable’? Are they destined to be shunned to the proverbial back burner, at the bottom of our list of priorities? And more importantly, who decides these priorities, and are they based on our own perceptions of the needs of other people?

Photographable or not, what I saw the first time I stepped into a flood relief camp will remain etched in my memory forever. It was a school that had effectively been converted into an asylum. I found this odd at first, but I suppose there’s no time for education when lives are at stake.

The enclosure, although massive, was overflowing with what seemed like 200 children below the age of 10. From afar, it almost looked like a regular school at recess time. But the closer we got, the bleaker things became.

The children’s faces, although gleeful and animated, were severely malnourished. Their jaundiced eyes looked up at us curiously as we walked in, eyeing the toys and trinkets in our hands. A few of them lay listlessly on dusty carpets under the open sky, and could barely muster the energy to partake in the activities we had planned for them.

 Doctors tend to patients at a relief camp in Sindh. — Photo courtesy Humanity Initiative Pakistan
Doctors tend to patients at a relief camp in Sindh. — Photo courtesy Humanity Initiative Pakistan

Their mothers looked at their faces with eyes that flashed with concern. Many of these women were pale and emaciated, but they insisted we examine their offspring for various medical issues ranging from scabbing skin infections to stomach pains.

Some of them bounced screaming toddlers on their laps, and a handful were holding bundled up newborns. Flies and mosquitos jumped from skin to skin, no doubt spreading infections and contaminating every place they landed.

Over and over, the women would beg us to provide their kids with more essentials. We asked: “And what do you need?” I suspected most of them didn’t even fully understand what we meant.

Disaster in numbers

Of the nearly 33 million individuals who have been displaced by the flooding crisis this year, 8.2 million are women of reproductive age. It is important to start with the numbers because, like photographs, they have a way of getting a reaction out of us.

Multiple studies indicate that the most vulnerable populations during times of disaster are women and children. This is the reason why organisations such as the Human Rights Watch have deemed it crucial to prioritise the rehabilitation of women and girls during this time.

The lives of women in resource-limited settings undergo a striking transformation after a crisis. Their traditional roles as caretakers are intensified, even as materials and resources decline rapidly. While the onus of looking after the young, old and infirm is on them, women face a triple threat in the form of reproductive and sexual health concerns, increased risk of gender-based violence, and greater susceptibility to malnourishment and infectious diseases.

Yet, cultural restrictions on what is an “appropriate” element of media coverage limit visibility of these issues, to the detriment of the women who need our help now more than ever.

I met one such woman at an IDP camp in Goth Bhago Khan Jamali. Having struggled with the language barrier all day, I was surprised when she asked for “iron dawai” in fluent Urdu. One look at her pale, bony face made it obvious that she was severely anaemic.

 A general view of a relief camp in Sindh. — Humanity Initiative Pakistan
A general view of a relief camp in Sindh. — Humanity Initiative Pakistan

To make matters more difficult for her, she was six months pregnant, with no access to even basic antenatal care. I asked her if there was a hospital nearby that she had access to. She said no, of course the baby would be born at home — the only hospital she knew of had been rendered inaccessible by floodwater.

According to the United Nations Population Fund (UNFPA), 650,000 of the flood affectees are pregnant women.

Pakistan had one of the highest rates of maternal mortality in Asia even before the onset of floods. Factoring in its cataclysmic after-effects, the situation can only be described as bleak.

In Sindh alone, over 1,000 health facilities are fully or partially destroyed, and a further 198 facilities have been destroyed in areas of Balochistan. Damage to infrastructure, including roads and key emergency routes, has further limited women’s access to healthcare services.

And yet, medical aid targeted towards these areas is shockingly deficient in Ob/Gyn doctors to specifically cater to the emergent needs of women. These areas are often too unsafe for an adequate number of female doctors to be part of each medical team. Tragically, this oversight and failure to supply key resources will cost many of these women their lives.

Rescue and relief efforts are being undertaken by various organisations, but experts on the ground say the problems extend further than that.

Need of the hour

One of these experts, Dr Raza Sayyed, is a surgical oncologist who is collaborating with Humanity Initiative Pakistan on various flood relief projects. According to Dr Raza, “The scale of the disaster is massive. No one organisation can tackle all of the challenges at once. What I really see missing is a unification of all of our efforts in the form of collaborations between various philanthropic organisations. Our end goal should not just be to rescue these individuals, but also to rehabilitate them, providing them with the tools they need to reclaim their lives.”

The need of the hour, then, is for robust alliances between state and non-governmental organisations. The shared goal of these efforts should be to provide holistic, equitable aid to the hardest-hit populations.

By prioritising rehabilitation and empowerment, and viewing members of the affected community as collaborators rather than victims, we can understand their challenges instead of predetermining them. And crucially, women’s well-being is directly linked to the well-being of other vulnerable groups. Rather than viewing their health as a secondary, lesser battle, it should be among our top priorities, as women are vital to the rebuilding of their own communities.

It is important to remember that displacement and sequestration are only one aspect of the challenges women are currently facing in these areas.

Dr Raza explains that “loss of property, livestock, livelihood — as well as a genuine threat to their life and safety — has had an indelible impact, particularly on women and children. Coupled with the stress of living and surviving at an IDP camp, it has taken a huge toll on mental health.”

With barely enough resources to provide specialist medical care to these individuals, it is uncertain when, and if, they will receive the psychosocial support that is so evidently lacking.

I met a young mother recently who clutched her newborn firmly against her chest, regarding me with a cool, defiant gaze. Unlike the other inhabitants of the IDP camp, she was nonplussed by the flurry around her, staying quiet and merely observing us dole out supplies and clothes for the children.

When she finally spoke, she said, “I don’t care about clothes or shoes. I wouldn’t have cared about food either. But I have this one to feed. If I don’t eat, how will I have milk to feed him?”

I was dumbstruck; I could not think of a better example of bravery. These resilient women are willing to sacrifice everything they have to look after their families. Deprived of their homes, their food, and in some cases, their dignity, they remain resolute and simply impossible to defeat.

These women are the unsung heroes of Pakistan, and we absolutely can’t let them down.

Header image: Women and children gather around doctors at a relief camp in Sindh. — Photo courtesy: Humanity Initiative Pakistan